Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore,
Int J Comput Assist Radiol Surg. 2015 Mar;10(3):317-27. doi: 10.1007/s11548-014-1084-y. Epub 2014 Jun 13.
Positioning existing humeral implants into Asian patients poses significant challenges due to the inconsistent statistical shapes between Western population and Asian population. Current humeral orthopedic fixation devices and implants have a generic shape and are not designed for Asian patients who exhibit different sizes and shapes compared to their Western counterparts for which present day designs have been based on. To address this problem, it is necessary to develop Asian-specific implants that accommodate the morphology of Asian humeri. Existing morphological studies of humeri in Asian populations are rare and most previous analyses are either based on the manual measurement of dry bones or the use of dual energy X-ray absorptiometry scans. The purpose of this pilot morphological study is to explore the characteristics of Asian humeri using statistical atlas-based analysis.
Forty-four CT scans of normal upper limbs were obtained from the National University Hospital, Singapore and used to construct statistical humerus atlases. The atlases were subsequently used to study the morphology of the humeri in an Asian population. Humeral shapes of different patient clusters were analyzed based on statistical shape models. Comparison between different clusters was conducted with regard to centerline, length, width and surface curvature.
The statistical humerus atlases reflected the mean shape and modes of variation of humeri in an Asian population. Analyses based on these atlases indicated that curvature and shape of the internal humeral canal were similar in males and females while humeral length and width were greater in males. Most importantly, surface curvatures were explicitly different between clusters.
Morphologic analysis based on statistical atlases is novel and useful to characterize the Asian humerus. The humerus demonstrates gender-specific morphology. This unique approach provides information that is useful to the clinician and biomedical engineer, not only in the modification of current or design of future humeral implants, but also in the precise dynamic positioning of Asian-specific humeral implants to Asian patients. Our findings support the need for further development of humeral implants, curvilinear robotics, and the questioning of whether gender-specific devices are necessary.
由于西方人群和亚洲人群的统计形状不一致，将现有的肱骨植入物定位到亚洲患者身上存在很大的挑战。目前的肱骨矫形固定装置和植入物具有通用的形状，而不是为与西方人群相比具有不同尺寸和形状的亚洲患者设计的，目前的设计是基于西方人群的。为了解决这个问题，有必要开发适合亚洲人肱骨形态的专用植入物。现有的亚洲人群肱骨形态学研究很少，以前的大多数分析要么是基于对干骨的手动测量，要么是使用双能 X 射线吸收法扫描。本研究旨在探索基于统计图谱分析的亚洲人肱骨的特征。
从新加坡国立大学医院获得 44 例正常上肢的 CT 扫描，用于构建统计肱骨图谱。随后，使用这些图谱研究亚洲人群中肱骨的形态。根据统计形状模型分析不同患者群体的肱骨形状。对不同集群之间的中线、长度、宽度和表面曲率进行比较。
统计肱骨图谱反映了亚洲人群中肱骨的平均形状和变化模式。基于这些图谱的分析表明，男性和女性的肱骨内部管腔的曲率和形状相似，而男性的肱骨长度和宽度较大。最重要的是，集群之间的表面曲率明显不同。
基于统计图谱的形态分析是新颖的，有助于描述亚洲肱骨。肱骨具有性别特异性形态。这种独特的方法为临床医生和生物医学工程师提供了有用的信息，不仅有助于修改现有的肱骨植入物或设计未来的肱骨植入物，还有助于将亚洲特定的肱骨植入物精确地定位到亚洲患者身上。我们的研究结果支持进一步开发肱骨植入物、曲线机器人以及质疑是否需要针对特定性别的设备的必要性。
